Abstract

Purpose: To evaluate the effect of intravitreal bevacizumab (IVB) injection on central macular thickness (CMT) in patients with diabetic macular edema (DME) associated with epiretinal membrane (ERM) and compare the results to those with DME without ERM. Methods: 54 eyes of 54 patients with DME were included in this prospective comparative case series. Twenty-eight patients had ERM. All patients received 2.5 mg/ 0.1 ml IVB. The primary outcome measure was the change in central macular thickness (CMT) and the secondary outcome measure was the change in best corrected visual acuity (BCVA), one month after the IVB injection. Results: All the patients completed 1-month follow-up. One month after the IVB injection, there was no statistically significant reduction in terms of CMT for the ERM group (22.64 ± 70.1 μm; P = 0.099), unlike eyes with DME alone (60.34 ± 88.5 µm; P = 0.002). Patients with ERM had a -0.09 ± 0.14 log MAR improvement in their BCVA (P =0.001) vs. 0.03 ± Log MAR change in the patients who did not have ERM (P = 0.37). Conclusion: In this study, intravitreal bevacizumab resulted in improvement in BCVA in patients who had DME associated with ERM. However, in patients who only had DME, despite a reduction in CMT, no improvement in BCVA occurred. Future randomized clinical trials are warranted to precisely assess the effect of bevacizumab on the ERM.

Highlights

  • Diabetic macular edema (DME) is the most common cause of visual impairment in diabetic patients [1]

  • Few studies have investigated the effect of epiretinal membrane (ERM) on the therapeutic effects of anti-VEGFs agents on DME [10,11] and there is no study reported the impact of ERM on bevacizumab effects for treating DME

  • This is the first report describing the effects of intravitreal bevacizumab (IVB) on DME associated with ERM

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Summary

Introduction

Diabetic macular edema (DME) is the most common cause of visual impairment in diabetic patients [1]. The estimated prevalence of DME ranged from 3.15% to 19.96% in patients with diabetes, but the prevalence of this disorder was notably variable according to the population and method of the study [2]. According to the ETDR study, macular laser photocoagulation was considered the standard treatment for eyes with clinically significant DME for many years [3]. After the introduction of antivascular endothelial growth factor (anti-VEGFs) drugs, many studies have shown superiority of these agents to macular photocoagulation in DME. The anti-VEGF medications are standard treatment for center-involving DME [4,5]. Romanian Journal of Ophthalmology 2018; 62(3): 212-216

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